Eight emergencies; all taken by ambulance.
A fairly quiet day. The sun shone and I got some reading in, which made a change. Later in the day I sat on stand-by at Trafalgar Square and watched an excellent performance by this steel band. I love that sound anyway (always reminds me of sunny weather) but these kids were playing those metal bins with so much passion and expertise that I almost believed I was listening to a recording.
Hawk man was around earlier too but he was having a bit of trouble with his bird. The predator had flown onto the roof of the National Gallery to scare off the seagulls - many of them were still circling around screaming their beaks off – and was intent on staying there, regardless of the man’s desperate efforts to entice him down with some sort of colourful plastic lure which he held in his heavily gloved hand. I didn’t blame the bird to be honest – what he was offering was far less attractive than a good chunky seagull.
Anyway, a few hours into my shift and I’m off to a 35 year-old male who had overdosed on GHB at a club. A crew arrived just ahead of me (I had been sent a long way) and I asked if I was required. They didn’t think so but I hovered until I got a thumbs-up from my colleague and off I went, back to my area.
Then to an 88 year-old male who was ‘blacking out’, according to the carer who met me when I arrived on scene. I didn’t sense any real concern from the carer but the man was lying across his bed, looking very unwell. He also smelled of old urine, so what the carer was actually doing to ‘care’ for him I don’t know. He was taken to hospital by the ambulance crew after my obs were completed. He was a bit confused and obviously worried about his new habit of falling down without warning.
Across the bridge and south for a 45 year-old woman who was fitting at a railway station. Her son was with her and a couple of bystanders had been helping before I arrived. They told me that she had been fitting on the pavement for less than a minute. Both were French and spoke little English. As you know, my French is rusty at best but I got a few details and communicated a little bit back. The woman was conscious but confused. Her son said she was epileptic but the woman didn’t know if she was or not. The problem I had was that she either didn’t know because she was confused (as a result of fitting) or the language barrier had mixed the messages and one or neither had understood me.
In the end, the rail staff produced a fluent French-speaking lady who helped out. The crew arrived and order was restored. I will, at some point, go over my French and take lessons. I might be too old for this language lark though.
As I raced to my next call, which had come in as a 27 year-old male with chest pain, I nearly got T-boned by another car as it cut across a junction. I was visible and had my noise and lights on, so he had no excuse. Luckily I was going at a speed that enabled me to get around him but it was close. There’s not much I can do if some idiot wants to keep driving towards me and I have little room to manoeuvre. Sometimes I feel I’m pushing my luck.
The chest pain turned out to be abdominal pain and it probably wasn’t serious. The guy had been in pain for about 30 minutes and had a history of it. He had been drinking all the day yesterday and watching cricket in the sun. The staff of the underground station had called us because the patient couldn’t walk. It’s possible that he was dehydrated – he may even have a little stone in his kidney.
Then I met an honest-to-God salt of the Earth type. He was up on the tenth floor of a block of flats. I walked in as the door was opened by an elderly lady who could barely stand up and was guided to him. He was sitting on the sofa and he looked up at me and smiled.
“Allo son, sorry to waste your time” he said, “but I’ve got this pain and I really didn’t want to trouble ya...I tried to get the papers up to ‘er but the pain wouldn’t stop”
He was an East London man, the real deal Cockney and he was experiencing chest pain. He had cardiac problems and a history of hypertension. The woman wasn’t his wife (as I had assumed), it was a friend of his that he runs errands for “on account of ‘er not being able to get arand”.
He had been collecting the lady’s newspaper, as was his daily routine, when the pain started. It got worse but he said “I was determined to get the paper to her”. He collapsed on her sofa and she called an ambulance. Now she sat across from us, concern etched on her face.
I carried out my obs and included an ECG. He was persistently bradycardic, diaphoretic and the pain lingered but did not increase. His blood pressure was good though, so I gave him GTN and aspirin and chatted with him until I could see a change in his demeanour. I asked him how the pain was now and he said that it was much better.
I continued to get to know him over the next few minutes until the ambulance crew arrived. The man had been a soldier and had fought during the Normandy landings. He told me that his unit had lost 800 men in one hour of fighting; I have no idea how that must have been but I was looking at a man who had been through that and was now sitting on a sofa with angina, worrying more about taking care of his lady friend who was “a diamond”.
We got him into the ambulance (it took a bit of persuasion to convince him that he needed to go in the chair) and before I left to get on with my paperwork, he chatted some more and referred to me by name. I had only told him my name once, as I do with all my patients, so I was surprised that he had remembered it. I also liked him because he called me ‘son’ – made me feel young ;-)
A long run from E1 to SE1 for an 82 year-old male who was fitting. An ambulance pulled in ahead of me and I went up to see the patient with the crew. He was in bed, surrounded by his family and he was shivering. He hadn’t been fitting; he had a chest infection and was running a temperature. He hadn’t seen his doctor about it and now he was feeling rough. I was on scene only because the crew were both EMT’s and for fitting a paramedic has to be present in case drugs are required but it was clear that I was surplus to requirements and so I checked with the attendant and left.
At Victoria I found myself looking at a familiar face. He was an alcoholic who frequently found himself on police cell floors, pretending to be unconscious. When he is ‘woken up’ he hurls abuse and becomes violent. I’ve seen him being pinned to the floor by as many as four police officers. He has no respect and he has no intention of getting any. Two PCSO’s were with him because he had told them he was a diabetic and had forgotten/lost his insulin. This was rubbish, of course, he had no other condition than alcoholism and a bad attitude.
I cancelled the ambulance because he was fully conscious and refusing any attempt on my part to get basic obs., including a BM. He was sitting in a corner, outside a Baker’s shop and I realised that the proprietor had probably called the police just to get rid of him. He wasn’t the best advertising they could wish for.
He is a young, wirey man and he can change from reasonable to aggressive in a split second, so I was being very careful not to say the wrong thing. The PCSO’s were trying to persuade him to comply but he just wasn’t interested – he made a few sexist remarks, designed for the attention of the female PCSO but they were largely ignored.
I gave it twenty minutes and three attempts but he refused each time; the intonation and volume of his voice changed and I knew a fourth request was going to end in tears. I left him with the PCSO’s and they probably spent the rest of their shift trying to move him.
Finally, a 45 year-old male who was sitting in a car in north London. He was dizzy and vomiting. Every time he moved he threw up violently – there was no chest pain, nor any other symptom. He was a big man with a history of hypertension. His lady companion (she insisted they were long-standing friends only) was by his side. She was extremely concerned about him and I found it difficult to get a clear two-way conversation going with him because every time I asked a question, she would interject then put her fingers to her lips and stare apologetically. She kept doing it though, so I guess she was nervous and worried.
The man had to be carefully moved from the driver’s seat of his car to the ambulance when it arrived. He was sick a few times on the way but again, no other symptoms. I have seen this before and I am not convinced that there is a cardiac origin. I’ve seen it as vertigo. Any movement of the head caused a spinning sensation, leading to vomiting. It’s a very uncomfortable experience.
He refused an anti-emetic (the hospital was only a few minutes away anyway) and said he felt a little better once he was stable on the trolley bed. His friend, who was still flapping a little, told me that she had known him for years and that they went places together and did all sorts of things over the years. I had a sense of a mutually plutonic relationship that had become a real and very solid friendship over time. It seemed to me that, no matter what the man had asked of her, she would have been willing to do it for the love of him.
Hawk man was around earlier too but he was having a bit of trouble with his bird. The predator had flown onto the roof of the National Gallery to scare off the seagulls - many of them were still circling around screaming their beaks off – and was intent on staying there, regardless of the man’s desperate efforts to entice him down with some sort of colourful plastic lure which he held in his heavily gloved hand. I didn’t blame the bird to be honest – what he was offering was far less attractive than a good chunky seagull.
Anyway, a few hours into my shift and I’m off to a 35 year-old male who had overdosed on GHB at a club. A crew arrived just ahead of me (I had been sent a long way) and I asked if I was required. They didn’t think so but I hovered until I got a thumbs-up from my colleague and off I went, back to my area.
Then to an 88 year-old male who was ‘blacking out’, according to the carer who met me when I arrived on scene. I didn’t sense any real concern from the carer but the man was lying across his bed, looking very unwell. He also smelled of old urine, so what the carer was actually doing to ‘care’ for him I don’t know. He was taken to hospital by the ambulance crew after my obs were completed. He was a bit confused and obviously worried about his new habit of falling down without warning.
Across the bridge and south for a 45 year-old woman who was fitting at a railway station. Her son was with her and a couple of bystanders had been helping before I arrived. They told me that she had been fitting on the pavement for less than a minute. Both were French and spoke little English. As you know, my French is rusty at best but I got a few details and communicated a little bit back. The woman was conscious but confused. Her son said she was epileptic but the woman didn’t know if she was or not. The problem I had was that she either didn’t know because she was confused (as a result of fitting) or the language barrier had mixed the messages and one or neither had understood me.
In the end, the rail staff produced a fluent French-speaking lady who helped out. The crew arrived and order was restored. I will, at some point, go over my French and take lessons. I might be too old for this language lark though.
As I raced to my next call, which had come in as a 27 year-old male with chest pain, I nearly got T-boned by another car as it cut across a junction. I was visible and had my noise and lights on, so he had no excuse. Luckily I was going at a speed that enabled me to get around him but it was close. There’s not much I can do if some idiot wants to keep driving towards me and I have little room to manoeuvre. Sometimes I feel I’m pushing my luck.
The chest pain turned out to be abdominal pain and it probably wasn’t serious. The guy had been in pain for about 30 minutes and had a history of it. He had been drinking all the day yesterday and watching cricket in the sun. The staff of the underground station had called us because the patient couldn’t walk. It’s possible that he was dehydrated – he may even have a little stone in his kidney.
Then I met an honest-to-God salt of the Earth type. He was up on the tenth floor of a block of flats. I walked in as the door was opened by an elderly lady who could barely stand up and was guided to him. He was sitting on the sofa and he looked up at me and smiled.
“Allo son, sorry to waste your time” he said, “but I’ve got this pain and I really didn’t want to trouble ya...I tried to get the papers up to ‘er but the pain wouldn’t stop”
He was an East London man, the real deal Cockney and he was experiencing chest pain. He had cardiac problems and a history of hypertension. The woman wasn’t his wife (as I had assumed), it was a friend of his that he runs errands for “on account of ‘er not being able to get arand”.
He had been collecting the lady’s newspaper, as was his daily routine, when the pain started. It got worse but he said “I was determined to get the paper to her”. He collapsed on her sofa and she called an ambulance. Now she sat across from us, concern etched on her face.
I carried out my obs and included an ECG. He was persistently bradycardic, diaphoretic and the pain lingered but did not increase. His blood pressure was good though, so I gave him GTN and aspirin and chatted with him until I could see a change in his demeanour. I asked him how the pain was now and he said that it was much better.
I continued to get to know him over the next few minutes until the ambulance crew arrived. The man had been a soldier and had fought during the Normandy landings. He told me that his unit had lost 800 men in one hour of fighting; I have no idea how that must have been but I was looking at a man who had been through that and was now sitting on a sofa with angina, worrying more about taking care of his lady friend who was “a diamond”.
We got him into the ambulance (it took a bit of persuasion to convince him that he needed to go in the chair) and before I left to get on with my paperwork, he chatted some more and referred to me by name. I had only told him my name once, as I do with all my patients, so I was surprised that he had remembered it. I also liked him because he called me ‘son’ – made me feel young ;-)
A long run from E1 to SE1 for an 82 year-old male who was fitting. An ambulance pulled in ahead of me and I went up to see the patient with the crew. He was in bed, surrounded by his family and he was shivering. He hadn’t been fitting; he had a chest infection and was running a temperature. He hadn’t seen his doctor about it and now he was feeling rough. I was on scene only because the crew were both EMT’s and for fitting a paramedic has to be present in case drugs are required but it was clear that I was surplus to requirements and so I checked with the attendant and left.
At Victoria I found myself looking at a familiar face. He was an alcoholic who frequently found himself on police cell floors, pretending to be unconscious. When he is ‘woken up’ he hurls abuse and becomes violent. I’ve seen him being pinned to the floor by as many as four police officers. He has no respect and he has no intention of getting any. Two PCSO’s were with him because he had told them he was a diabetic and had forgotten/lost his insulin. This was rubbish, of course, he had no other condition than alcoholism and a bad attitude.
I cancelled the ambulance because he was fully conscious and refusing any attempt on my part to get basic obs., including a BM. He was sitting in a corner, outside a Baker’s shop and I realised that the proprietor had probably called the police just to get rid of him. He wasn’t the best advertising they could wish for.
He is a young, wirey man and he can change from reasonable to aggressive in a split second, so I was being very careful not to say the wrong thing. The PCSO’s were trying to persuade him to comply but he just wasn’t interested – he made a few sexist remarks, designed for the attention of the female PCSO but they were largely ignored.
I gave it twenty minutes and three attempts but he refused each time; the intonation and volume of his voice changed and I knew a fourth request was going to end in tears. I left him with the PCSO’s and they probably spent the rest of their shift trying to move him.
Finally, a 45 year-old male who was sitting in a car in north London. He was dizzy and vomiting. Every time he moved he threw up violently – there was no chest pain, nor any other symptom. He was a big man with a history of hypertension. His lady companion (she insisted they were long-standing friends only) was by his side. She was extremely concerned about him and I found it difficult to get a clear two-way conversation going with him because every time I asked a question, she would interject then put her fingers to her lips and stare apologetically. She kept doing it though, so I guess she was nervous and worried.
The man had to be carefully moved from the driver’s seat of his car to the ambulance when it arrived. He was sick a few times on the way but again, no other symptoms. I have seen this before and I am not convinced that there is a cardiac origin. I’ve seen it as vertigo. Any movement of the head caused a spinning sensation, leading to vomiting. It’s a very uncomfortable experience.
He refused an anti-emetic (the hospital was only a few minutes away anyway) and said he felt a little better once he was stable on the trolley bed. His friend, who was still flapping a little, told me that she had known him for years and that they went places together and did all sorts of things over the years. I had a sense of a mutually plutonic relationship that had become a real and very solid friendship over time. It seemed to me that, no matter what the man had asked of her, she would have been willing to do it for the love of him.
Be safe.
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5 comments:
Refused an anti-emetic? Fool! The one and only time I had a bout of vertigo(that lasted over three weeks and I thought I was dying!) I couldn't wait for it to take effect. Glad to hear someone else appreciates what some of our elderly have lived through and can still make the effort to smile. Some of those young drunks should take heed, would they cope? I think not.
Take care. Gill
Hi. Love reading your blog, only just managing to catch up on it, I would just like to say a big thank you for your comments about the steel bands that were playing on this day, the photo on your blog is of the steel band I am actually involved with www.croydonsteelorchestra.co.uk but there were 5 other bands there all putting thier heart & soul into playing. I did see a FR car and I did wonder if it was you, If I had known I would have come and spoke just to say what a great job you AND all your colleages do.
Keep up the good work, with the writing and the life saving.
Be safe and take care.
Paul
Paul
Thanks. It was a pleasure to listen to. If you are on the Square and you see me, drop by and say hello.
First off I'm not sure if you mind me reading back on your older blogs and commenting on them, If you would prefer me not to comment on your older blogs and just let me know and I'll keep the comments to the current blogs.
I wasn't sure what the difference was between an EMT and a paramedic mentioned in this blog so I did some research. Anyway I was wondering what can a paramedic do that an EMT is not permitted to do?
Also I smiled a bit at the comment above me *that happened in 2007*. My gosh the world is small lol.
Japhia
Japhia
No problem with commenting on older posts.
A paramedic is a registered practitioner, an EMT is not. Paramedics give cardiac and other drugs and can use invasive skills, such as cannulation and intubation and EMTs generally can't.
Legally, the paramedic is the clinical lead and therefore responsible for the patient's care, even if the EMT is attending that patient.
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